Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $727.97 / $727.97 / $2,817.24	Facility		$727.97	$727.97	$2,817.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $637.92 / $770.79 / $1,027.72	Professional		$637.92	$770.79	$1,027.72
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,241.26 / $1,630.12 / $1,630.12	Professional		$1,241.26	$1,630.12	$1,630.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,018.60 / $1,018.60 / $1,630.12	Facility		$1,018.60	$1,018.60	$1,630.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $743.58 / $743.58 / $2,056.13	Professional		$743.58	$743.58	$2,056.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,499.71 / $1,630.12 / $3,097.23	Professional		$1,499.71	$1,630.12	$3,097.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $727.97 / $727.97 / $2,817.24	Facility		$727.97	$727.97	$2,817.24
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $637.92 / $799.34 / $1,324.91	Professional		$637.92	$799.34	$1,324.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,104.09 / $2,223.30 / $3,211.60	Professional		$1,104.09	$2,223.30	$3,211.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,018.60 / $1,018.60 / $1,630.12	Facility		$1,018.60	$1,018.60	$1,630.12
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $743.58 / $743.58 / $2,056.13	Professional		$743.58	$743.58	$2,056.13
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,246.08 / $1,246.08 / $1,551.57	Facility		$1,246.08	$1,246.08	$1,551.57
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,246.08 / $1,551.57 / $1,582.60	Professional		$1,246.08	$1,551.57	$1,582.60
United Facility/Professional Professional Modifier Low / Median / High Price $762.44 / $918.78 / $1,470.05	Professional		$762.44	$918.78	$1,470.05